Flashcards in Section 18G - Suicide Prevention Deck (88):
Suicide is the act of _____ killing oneself, based on the victim's intent and understanding of the probable consequences of his or her actions.
Roughly how many Americans commit suicide each year?
30,000 (Almost twice the number killed by homicide.)
During 2011, the Air Force suffered _____ Regular Air Force suicides.
42. (A rate of 12.8 suicides for every 100,000 Airmen.)
Suicide is the _______ leading cause of death among Regular Air Force personnel.
Third. (Death by accidents is second.)
During 2011, 27 Air Reserve Component (ARC) and ______ civilian employee suicides occurred.
Within the Air Force, what are the most common stressors among those who commit suicide?
Relationship, legal, mental health, financial hardship and work problems.
Within the Air Force, those over 35 are at less risk for suicide than those under 24 years old. T/F
False. (These groups are at equal risk.)
Is any particular ethnic, racial, age, or rank group spared from suicide?
No. (However, men do commit suicide at a rate four times greater than women.)
What serious problems may Air Force suicides create?
1) An unnecessary loss of human life; 2) distress in the victim's family and Air Force community; 3) direct impact on mission sustainability (loss of skills, experience and productivity); and 4) loss of the economic value invested in the victim (anticipated services, training costs and replacement costs).
What are the two personal perceptions that place someone at risk for suicide?
1) Feeling like they don't belong or fit in anywhere; and 2) feeling like a burden to others.
What is the third important piece in the dynamics of suicide?
Acquiring the capability to take one's own life. (For Airmen, the most common step is acquisition of a firearm.)
Among Airmen feeling suicidal, which ones may be at more risk for suicide?
Those who already possess the means or have training in the use of lethal means.
All military suicides are preventable. T/F
False. (However, definite steps can be taken to taken to reduce the number of suicides.)
Suicide prevention efforts should be _____ with all the force and effectiveness of other command initiatives.
At what stage may individuals considering suicide be most open to assistance and support from a wingman, friend or professional?
After other efforts to cope with or manage their problems have failed and they feel there are no other options.
Name three suicide risk factors.
Any three of the following; 1) severe, prolonged or unmanageable stress; 2) difficulty coping or functioning; 3) lack of social support or social isolation; 4) escalating alcohol or drug use; 5) difficulty sleeping; and 6) feelings of hopelessness or depression.
Through CY 2009 to CY 2011, more than ______ % of Airmen who died by suicide were receiving treatment for mental health concerns.
Depression is a significant risk factor associated with suicide. Name five signs that can help you determine if someone may be suffering from depression and distress.
Any five of the following; agitation, alcohol misuse, anxiety, apathy, avoiding recreation, constant fatigue, decreased appetite, decreased libido, depression, difficulty coping, disciplinary problems, excessive sleeping, feeling "blah", feeling guilty, feeling overwhelmed, feeling worthless, financial problems, hopelessness, increased appetite, indecisiveness, insomnia, irritability, loss of interest, low energy, low self-esteem, poor concentration, poor personal hygiene, poor work performance, relationship difficulties, restlessness, sadness, social isolation, social withdrawal, suicidal ideation, weight gain, or weight loss.
Since CY09, ______% of Airmen who died by suicide faced legal problems at the time of their deaths.
Why is being under investigation for a suspected criminal offense stressful, especially if it is highly embarrassing?
There is stress in not knowing the final outcome of the investigation, the threat to one's career and/or ability to find work after separation, and rejection by loved ones.
Many Air Force suicide victims were experiencing significant financial problems at the time of their deaths. T/F
Why should commanders recognize financial problems as symptomatic of ineffective
It is another potential point of intervention that might reduce the overall Air Force suicide rate.
Since CY09, _____% of Airmen who died by suicide experienced a failed relationship in the months prior to their death and ____% experienced work-related problems.
Many suicide victims experienced simultaneous work and relationship problems at the time of their deaths. T/F
Why is a combination of work-related problems and personal problems particularly dangerous for suicide victims?
Because it leaves the victim with no safe haven. (A healthy, happy relationship can serve an important protective function against many other kinds of stress.)
When a fellow Airman, friend or family member demonstrates observable signs of distress, what actions should you take?
Ask them what may be troubling them.
Most suicides are impulsive. T/F
False. (Typically, individuals come to focus on suicide as their only solution over a period of time.)
List five examples of verbal and behavioral hints of suicidal ideation.
1) Acquiring the means to commit suicide; 2) making suicidal remarks; 3) giving away cherished possessions; 4) writing a will; and 5) preoccupation with death.
Some communications of suicidal intentions are direct (i.e., "I'm going to get a rifle from a pawnshop and kill myself.") others are indirect. Give examples of indirect statements of suicidal intention.
Goodbye statements, making preparations such as writing a will or increasing life insurance, or comments that everyone would be better off if he or she was dead.
Why are vague allusions to suicide easy to dismiss?
Because of their passive nature and because many people mistakenly believe that those who talk about suicide are not likely to actually do it. Every suicidal remark must be taken seriously.
Any self-injury intended to end one's life should be treated as a suicide attempt, regardless of it's severity. T/F
Is the severity of injury during a suicide attempt an accurate indicator of the lethality of the intent?
No. (Any level of self-injury is serious and should be addressed by mental health professionals.)
Actual suicides combine high ______ in the selected method and a low probability of ______.
Do suicides increase during the holidays?
No. (Despite widespread belief, no such relationship has been noted in the Air Force.)
Effectively addressing suicide requires a carefully integrated and systematic community approach that does what two things?
1) Prevents the factors contributing to suicide; and 2) identifies, diagnoses and treats those at risk.
What does the community approach to suicide prevention rely on?
1) Active leadership involvement in the full range of Air Force suicide prevention activities; and 2) the engagement of concerned wingmen.
Military commanders have the authority to compel behavior, but they are also responsible for the health, well-being and morale of their subordinates. T/F
True. (This applies from four-star generals to the frontline supervisor.)
May the obligations of leadership in regards to suicide prevention be transferred to specialists such as psychiatrists, psychologists, social workers or chaplains?
No. (Specialists provide services in support of command responsibilities.)
Since CY09, what percentage of Airmen who died by suicide were seen by Air Force mental health services in the month prior to their deaths?
30%. (However, 100% were seen by their supervisors and peers.)
Why is the supervisor a central player in suicide prevention?
He or she is in a position to see any changes in performance or behavior that may signal a problem.
What are some typical reasons front-line supervisors fail at suicide prevention?
1) Not paying enough attention to their subordinates' personal needs; 2) not recognizing warning signs; 3) trying to "protect" subordinates from the Air Force; and 4) failing to take the proper action when needed.
How can supervisors best help subordinates limit the negative impact of personal problems on their careers?
Engage in problems early to ensure subordinates get the help they need to improve or maintain peak performance.
What should happen when suicide risk has been identified?
Appropriate professional resources should be obtained and applied to the problem.
Appropriate treatment requires commitment and assumption of responsibility at the _____ level, and dedicated competence at the ______ level.
Command level; support level.
What resource helps supervisors and wingmen identify appropriate helping agencies for suicide prevention?
The Airman's Guide for Assisting Personnel in Distress.
Who owns the Air Force Suicide Prevention Program (AFSPP)?
The Chief of Staff, US Air Force (CSAF).
Who serves as the Office of Primary Responsibility (OPR) for the Air Force Suicide Prevention Program (AFSPP)?
The Air Force Surgeon General (AF/SG)
What helping agencies typically evaluate and treat potential suicide victims at the installation level?
Installation mental health clinics.
What major shortcoming do helping agencies such as mental health clinics have in regard to suicide prevention?
They can only act when they are aware of the problem. (Individuals at risk must either seek help themselves or be brought into the healthcare system by others.)
What is the common fear many have with regard to seeking help at the mental health clinic?
That it will negatively impact their career.
The vast majority of Airmen who receive mental health care in Air Force clinics suffer no adverse career outcomes. T/F
True. (97% do not)
Mental health providers must disclose what information to commanders?
Safety issues (such as suicidal or violent thoughts) and fitness for duty issues. (All other information is private.)
If you visit a mental health provider, will your commander be contacted?
No, unless there is a safety-related issue or mission impairment.
What program did the Air Force institute to promote help-seeking for suicidal Airmen with legal or administrative problems?
The Limited Privilege Suicide Prevention (LPSP) program, according to AFI 44-109
What does the Limited Privilege Suicide Prevention (LPSP) program allow suicidal Airmen to receive without risk of further incriminating themselves?
Mental health care.
Who is most likely to spot a potential suicide victim?
Friends, coworkers and immediate supervisors. (They are most likely to notice signs of depression and hear suicidal comments.)
_______ concerns of a potential suicide victim the chain of command.
Communicate. (Post-suicide reviews often find that no one person had "the whole picture.")
To help prevent suicide, Air Force members should encourage use of professional _______ services for personal problems.
Support. (Encouraging early help-seeking behavior is an important part of supervision, leadership and friendship.)
The Air Force Suicide Prevention Program (AFSPP) is founded upon what concept?
The decreasing suicides requires a community approach in which prevention and assistance are offered long before someone becomes suicidal.
The suicide prevention Integrated Product Team (IPT) published 11 Air Force Suicide Prevention Program initiatives in AFPAM 44-160, The Air Force Suicide Prevention Program. Name eight.
Any of the following: 1) leadership involvement; 2) addressing suicide prevention through PME; 3) guidelines for commanders (use of mental health services); 4) unit-based preventative services; 5) wingman culture; 6) investigate interview policy (hand-off policy); 7) post-suicide response (postvention); 8) Community Action Information Board (CAIB) and tools; and 11) suicide event tracking and analysis.
What type of environment do leaders build to prevent suicide?
One that promotes healthy/adaptive behaviors, fosters the wingman culture and encourages responsible help-seeking.
PME provides periodic and ______ suicide prevention training for Airmen.
Targeted. (Specifically oriented to the individual's rank and level of responsibility.)
PME suicide prevention teaches leaders about policies and practices that promote or discourage help-seeking. What skills do the leaders develop?
How to detect at-risk individuals and intervene with Airmen under stress.
Why are commanders encouraged to partner and consult with mental health staff about the health of their Airmen?
To improve their Airmen's duty performance. (Early self-referral yields the best outcome for the individuals and unit.)
When must a commander order an Airman to the Medical Treatment Facility (MTF)?
For 1) a mental health evaluation (per AFI 44-109); 2) a substance abuse assessment (per AFI 44-121); or 3) family advocacy issues (per AFI 40-301).
Unit leaders and helping agency professionals provide suicide prevention services at the worksite to increase access, encourage help-seeking and promote familiarity, rapport and trust with Airman and families. T/F
True. (Unit-based preventive services also improve unit cohesion and effectiveness.)
How do Wingmen help with suicide prevention?
Wingmen 1) foster a culture of early help-seeking; 2) recognize the signs and symptoms of distress in themselves and others and take protective action; and 3) practice healthy behaviors, make responsible choices and encourage others to do the same.
Airmen facing ______ or _______ action are at greater risk of suicide.
Criminal or administrative action. (They can easily feel isolated from family, friends and other social supports when needing them most.)
Following an investigative interview, Air Force investigators must hand off the accused directly to the member's commander or _______ through person-to-person documented contact.
First Sergeant. (The investigator will notify the unit representative.)
Who manages post-suicide responses?
Unit leaders. (They support affected personnel through the grieving process, consulting with chaplains and mental health staff as needed.)
In post-suicide responses, what should be carefully avoided?
Sensationalizing, glamorizing, romanticizing or giving undue prominence to suicide. (These practices are associated with suicide clusters, copycat suicides and increased suicide rates.)
According to AFI _____, Community Action Information Board (CAIB) and Integrated Delivery System (IDS) coordinate the activities of the various base helping agencies to achieve a synergistic impact on community problems and reduce suicide risk.
AFI 91-501, Community Action Information Board and Integrated Delivery System.
According to AFI 44-109, the Limited Privilege Suicide Prevention (LPSP) program offers increased legal protections and confidentiality for members, Information in the LPSP mental health file may be disclosed only to
1) Other medical personnel for treatment purposes; 2) a member's confinement military commander for legal proceedings against third parties; and 3) other authorized personnel with an official need to know.
Validated unit climate assessment tools can tap into the strengths and challenges of an organization and assist _____ in choosing strategies that enhance the well-being and resilience of their Airmen.
Commanders. (Some tools available to commanders, at no cost to the unit, include the equal opportunity's unit climate assessment, the Airman and Family Readiness Center's (A&FRC) support and resilience inventory and the Air Force culture assessment safety tool.)
What information is entered into the DoD Suicide Event Report (DoDSER)?
Information on all Air Force suicides and suicide attempts. (It identifies suicide risk factors and trends.)
DoD Suicide Event Report (DoDSER) statistical summary data may be provided to federal, state and local governments for health surveillance and research. T/F
True. (The report cannot contain personally identifiable information.)
A DoD Suicide Event Report (DoDSER) is submitted when active duty or federalized status Air Reserve Component (ARC) members attempt suicide. A DoDSER is submitted for what other populations?
For suspected suicides by active duty or equivalent ARC members, or active, full-time ANG members.
Basic DoD Suicide Event Report (DoDSER) demographic data from data fields 1-9 is tracked for which populations?
All 1) Department of Air Force civilian employee personnel suspected of dying by suicide; and 2) Selected Reserve (SELRES) and traditional Air Reserve Component (ARC) members suspected of dying by suicide while in civilian status or during a unit training assembly.
Who has the authority to conduct additional reviews of suicides by civilians and reserve members not in Title 10 status within their commands?
MAJCOMs, Field Operating Agencies (FOA), Direct Reporting Units (DRU) and the ANG.
A DoD Suicide Event Report (DoDSER) is completed within 30 days of the hospitalization or evacuation date, or within ______ days from the date the event was determined to be a suicide for active duty servicemembers, and ______ days for activated guardsmen and reservists.
60 days; 90 days
For reportable events that occur in a deployed setting, the DoD Suicide Event Report (DoDSER) is completed at the servicemember's deployed station. T/F
False. (DoDSER is completed at the servicemember's home station.)
Suicide prevention is whose responsibility?
To effectively prevent suicide, create a(n) _____ that encourages early help-seeking behavior.
What is the simple acronym the Air Force developed help facilitate personal engagement in suicide prevention?
ACE- Ask, Care, Escort.
When working with suicide prevention and the Ask, Care, Escort (ACE) model, why is it important to ask questions if you see or hear any of the warning signs of suicide?
To give people permission to talk about a subject that may be difficult to bring up.
When working with suicide prevention and the Ask, Care, Escort (ACE) model, what are some important ways to show you care?
1) Listen and allow them to share; 2) avoid judgmental statements or immediately trying to solve their problems; 3) accept they are in distress; 4) begin the process of getting them help; and 5) try to remove any means of self-harm, such as weapons or medications.
When working with suicide prevention and the Ask, Care, Escort (ACE) model, the final step is to escort the individual to the person or agency that can help. Why is this important?
If you leave them alone or send them alone to a chaplain or mental health clinic, they may change their mind on the way.